FDA Adverse Event
Malfunction
Summary report: N
SLINGS, CLIP
MDR report key: 3952100
·
Received June 18, 2014
Report
- Report Number
- 3007420694-2014-00072
- Event Type
- Malfunction
- Date Received
- June 18, 2014
- Manufacturer
- ARJOHUNTLEIGH POLSKA SP. ZO.O.
- Product Code
- IKX
- Report Source
- Manufacturer report
Narratives
Additional Manufacturer Narrative · 1
(B)(4). THIS APPEARS TO BE A "MALFUNCTION" TYPE OF EVENT NOT BECAUSE THERE WAS A TECHNICAL MALFUNCTION OF THE DEVICE, BUT SINCE DUE TO A USE ERROR THE DEVICE DID NOT PERFORM AS INTENDED. ADDITIONAL INFO WILL BE PROVIDED FOLLOWING THE CONCLUSION OF THE MANUFACTURER'S INVESTIGATION.
Description of Event or Problem · 1
(B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 358809 | SLINGS, CLIP | IKX | ARJOHUNTLEIGH POLSKA SP. ZO.O. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |